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Analysis of a Statewide Early Intervention Program for Young Children with ASD

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Abstract

We evaluated the effectiveness of a statewide Medicaid program providing in-home Early Intensive Behavioral Intervention services to young children with Autism Spectrum Disorder living in a rural southern state. Program effectiveness was assessed via the Assessment of Basic Language and Learning Skills-Revised (ABLLS-R). A multi-level growth model was used to show significant variation among children’s initial ABLLS-R scores and their growth trajectories. Hispanic children tended to have lower initial scores but demonstrated similar growth compared to their non-Hispanic peers. Children who were older at initial start in the program appeared to have higher initial composite scores and higher growth trajectories. Children in more populous counties had higher initial scores but grew at similar rates to children in more rural counties.

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References

  • Ben-Itzchak, E., & Zachor, D. A. (2007). The effects of intellectual functioning and autism severity on outcome of early behavioral intervention for children with autism. Research in Developmental Disabilities, 28(3), 287–303. https://doi.org/10.1016/j.ridd.2006.03.002

    Article  PubMed  Google Scholar 

  • Bibby, P., Eikeseth, S., Martin, N. T., Mudford, O. C., & Reeves, D. (2002). Progress and outcomes for children with autism receiving parent-managed intensive interventions. Research in Developmental Disabilities, 23(1), 81–104. https://doi.org/10.1016/s0891-4222(02)00095-1

    Article  PubMed  Google Scholar 

  • Biddle, J. (2018). Red county: County life expectancy profile. Retrieved from https://www.healthy.arkansas.gov/images/uploads/pdf/2017_Red_County_Report_2017.pdf.

  • Bono, M. A., Daley, T., & Sigman, M. (2004). Relations among joint attention, amount of intervention and language gain in autism. Journal of Autism and Developmental Disorders, 34, 495–505.

    Article  PubMed  Google Scholar 

  • Centers for Medicare and Medicaid Services. (2014). Medicaid and CHIP FAQs: Services to address autism. Department of Health and Human Services. Retrieved from https://www.medicaid.gov/federal-policy-guidance/downloads/faq-09-24-2014.pdf.

  • Cohen, H., Amerine-Dickens, M. S., & Smith, T. (2006). Early intensive behavioral treatment: Replication of the UCLA model in a community setting. Journal of Developmental and Behavioral Pediatrics, 27(S2), 145–155.

    Article  Google Scholar 

  • Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20(3), 775–803.

    Article  PubMed  Google Scholar 

  • Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2007). Outcome for children with autism who began intensive behavioral treatment between ages 4 and 7: A comparison controlled study. Behavior Modification, 31(3), 264–278. https://doi.org/10.1177/0145445506291396

    Article  PubMed  Google Scholar 

  • Eldevik, S., Titlestad, K. B., Aarlie, H., & Tønnesen, R. (2019). Community implementation of early behavioral intervention: Higher intensity gives better outcome. European Journal of Behavior Analysis. https://doi.org/10.1080/15021149.2019.1629781

    Article  Google Scholar 

  • Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2010). Using participant data to extend the evidence base for intensive behavioral intervention for children with autism. American Journal on Intellectual and Developmental Disabilities, 115(5), 381–405. https://doi.org/10.1352/1944-7558-115.5.381

    Article  PubMed  Google Scholar 

  • Eldevik, S., Hastings, R. P., Hughes, J. C., Jahr, E., Eikeseth, S., & Cross, S. (2009). Meta-analysis of early intensive behavioral intervention for children with autism. Journal of Clinical Child & Adolescent Psychology, 38, 439–450.

    Article  Google Scholar 

  • Eldevik, S., Hastings, R. P., Jahr, E., & Hughes, J. C. (2012). Outcomes of behavioral intervention for children with autism in mainstream pre-school settings. Journal of Autism and Developmental Disorders, 42(2), 210–220. https://doi.org/10.1007/s10803-011-1234-9

    Article  PubMed  Google Scholar 

  • Estrada, L., & Deris, A. R. (2014). A phenomenological examination of the influence of culture on treating and caring for Hispanic children with autism. International Journal of Special Education, 29(3), 4–15.

    Google Scholar 

  • Fenske, E. C., Zalenski, S., Krantz, P. J., & McClannahan, L. E. (1985). Age at intervention and treatment outcome for autistic children in a comprehensive intervention program. Analysis & Intervention in Developmental Disabilities, 5(1–2), 49–58. https://doi.org/10.1016/S0270-4684(85)80005-7

    Article  Google Scholar 

  • Flanagan, H. E., Perry, A., & Freeman, N. L. (2012). Effectiveness of large-scale community-based intensive behavioral intervention: A waitlist comparison study exploring outcomes and predictors. Research in Autism Spectrum Disorders, 6(2), 673–682.

    Article  Google Scholar 

  • Gobrial, E., & Raghavan, R. (2018). Calm child programme: Parental programme for anxiety in children and young people with autism spectrum disorder and intellectual disabilities. Journal of Intellectual Disabilities, 22(4), 315–327.

    Article  PubMed  Google Scholar 

  • Goin-Kochel, R. P., Myers, B. J., & Mackintosh, V. H. (2007). Parental reports on the use of treatments and therapies for children with autism spectrum disorders. Research in Autism Spectrum Disorders, 1(3), 195–209.

    Article  Google Scholar 

  • Goldstein, H. (2002). Communication intervention for children with autism: A review of treatment efficacy. Journal of Autism and Developmental Disorders, 32(5), 373–396. https://doi.org/10.1023/a:1020589821992

    Article  PubMed  Google Scholar 

  • Granpeesheh, D., Tarbox, J., & Dixon, D. R. (2009). Applied behavior analytic interventions for children with autism: A description and review of treatment research. Annals of Clinical Psychiatry, 21(3), 162–173.

    PubMed  Google Scholar 

  • Grindle, C. F., Hastings, R. P., Saville, M., Hughes, J. C., Huxley, K., Kovshoff, H., Griffith, G. M., Walker-Jones, E., Devonshire, K., & Remington, B. (2012). Outcomes of a behavioral education model for children with autism in a mainstream school setting. Behavior Modification, 36(3), 298–319. https://doi.org/10.1177/0145445512441199

    Article  PubMed  Google Scholar 

  • Harris, S. L., & Handleman, J. S. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four- to six-year follow-up. Journal of Autism and Developmental Disorders, 30(2), 137–142. https://doi.org/10.1023/a:1005459606120

    Article  PubMed  Google Scholar 

  • Howlin, P., Magiati, I., Charman, T., & MacLean, W. E., Jr. (2009). Systematic review of early intensive behavioral interventions for children with autism. American Journal of Intellectual and Developmental Disabilities, 114(1), 23–41. https://doi.org/10.1352/2009.114:23-41

    Article  Google Scholar 

  • Klintwall, L., Eldevik, S., & Eikeseth, S. (2013). Narrowing the gap: Effects of intervention on developmental trajectories in autism. Autism. https://doi.org/10.1177/1362361313510067

    Article  PubMed  Google Scholar 

  • Koegel, L. K., Koegel, R. L., Shoshan, Y., & McNerney, E. (1999). Pivotal response inter- vention II: Preliminary long-term outcomes data. Journal of the Association for Persons with Severe Handicaps, 24, 186–198.

    Article  Google Scholar 

  • Koegel, R. L., Shirotova, L., & Koegel, L. K. (2009). Antecedent stimulus control: Using orienting cues to facilitate first-word acquisition for nonresponders with autism. The Behavior Analyst, 32(2), 281–284. https://doi.org/10.1007/BF03392190

    Article  PubMed  PubMed Central  Google Scholar 

  • Lord, C., & Paul, R. (1997). Language and communication in autism. In D. L. Cohen & F. R. Volkmar (Eds.), Handbook of autism and pervasive developmental disorders (2nd ed., pp. 195–225). Wiley.

    Google Scholar 

  • Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3–9.

    Article  PubMed  Google Scholar 

  • Lovaas, O. I., & Smith, T. (1988). Intensive behavioral treatment for young children with autism. In B. B. Lahey & A. E. Kazdin (Eds.), Advances in clinical child psychology (Vol. 11, pp. 285–324). Plenum.

    Chapter  Google Scholar 

  • Maenner, M. J., Shaw, K. A., Baio, J., Washinton, A., Patrick, M., DiRienzo, M…., & Dietz, P. (2020). Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2016. MMWR Surveillance Summaries, 69(4), 1-12

  • Magiati, I., Charman, T., & Howlin, P. (2007). A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist nursery provision for children with autism spectrum disorders. Journal of Child Psychology and Psychiatry, 48, 803–812. https://doi.org/10.1111/j.1469-7610.2007.01756.x

    Article  PubMed  Google Scholar 

  • National Autism Center. (2015). Findings and conclusions: National standards project, phase 2. Author.

  • Newsom, C., & Rincover, A. (1989). Autism. In E. J. Mash & R. A. Barkley (Eds.), Treatment of childhood disorders (pp. 286–346). Guilford.

    Google Scholar 

  • Paparella, T., & Freeman, S. (2015). Methods to improve joint attention in young children with autism: A review. Pediatric Health, Medicine and Therapeutics, 6, 65–78. https://doi.org/10.2147/PHMT.S41921

    Article  PubMed  PubMed Central  Google Scholar 

  • Partington, J. W. (2010). The assessment of basic language and learning skills-revised. Behavior Analysts.

    Google Scholar 

  • Partington, J. W., & Bailey, A. (2014). Using normative data from typically developing children on the ABLLS=R® to guide program development for children with Autism. Partington Behavior Analysts. Retrieved from [https://cdn.shopify.com/s/files/1/2784/0734/files/This_report.pdf?1920622698425001997].

  • Partington, J. W., Bailey, A., & Partington, S. W. (2018). A pilot study examining the test–retest and internal consistency reliability of the ABLLS-R. Journal of Psychoeducational Assessment, 36(4), 405–410. https://doi.org/10.1177/0734282916678348

    Article  Google Scholar 

  • Partington, J. W., & Sundberg, M. L. (1998). The assessment of basic language and learning skills. Behavior Analysts.

    Google Scholar 

  • Pellecchia, M., Iadarola, S., & Stahmer, A. C. (2019). How meaningful is more? Considerations regarding intensity in early intensive behavioral intervention. Autism. https://doi.org/10.1177/1362361319854844

    Article  PubMed  Google Scholar 

  • Reichow, B. (2012). Overview of meta-analyses on early intensive behavioral intervention for young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(4), 512–520. https://doi.org/10.1007/s10803-011-1218-9

    Article  PubMed  Google Scholar 

  • Reichow, B., Barton, E. E., Boyd, B. A., & Hume, K. (2012). Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). The Cochrane Database of Systematic Reviews, 10, CD009260. https://doi.org/10.1002/14651858.CD009260.pub2

    Article  PubMed  Google Scholar 

  • Remington, B., Hastings, R. P., Kovshoff, H., Degli Espinosa, F., Jahr, E., Brown, T., Alsford, P., Lemaic, M., & Ward, N. (2007). Early intensive behavioral intervention: Outcomes for children with autism and their parents after two years. American Journal on Mental Retardation, 112(6), 418–438.

    Article  PubMed  Google Scholar 

  • Rhodes, R. L., Ochoa, S. H., & Ortiz, S. O. (2005). Assessing culturally and linguistically diverse students: A practical guide. Guilford.

    Google Scholar 

  • Rogge, N., & Janssen, J. (2019). The economic costs of autism spectrum disorder: A literature review. Journal of Autism and Developmental Disorders, 49(7), 2873–2900. https://doi.org/10.1007/s10803-019-04014-z

    Article  PubMed  Google Scholar 

  • Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-year outcome and predictors. American Journal of Mental Retardation, 110(6), 417–438. https://doi.org/10.1352/0895-8017(2005)110[417:IBTFCW]2.0.CO;2

    Article  PubMed  Google Scholar 

  • Scarpa, A., Jensen, L.S., Gracanin, D., Ramey, S.L., Dahiya, A.V., Ingram, L.M., ... Ruble, L. (2020). Access to autism spectrum disorder services for rural appalachian citizens. Journal of Appalachian Health 2(1), 25–40.

  • Sherer, M. R., & Schreibman, L. (2005). Individual behavioral profiles and predictors of treatment effectiveness for children with autism. Journal of Consulting and Clinical Psychology, 73, 525–538. https://doi.org/10.1037/0022-006X.73.3.525

    Article  PubMed  Google Scholar 

  • Smith, T., & Iadarola, S. (2015). Evidence base update for autism spectrum disorder. Journal of Clinical Child and Adolescent Psychology, 44(6), 897–922. https://doi.org/10.1080/15374416.2015.1077448

    Article  PubMed  Google Scholar 

  • Smith, T. (2010). Early and intensive behavioral intervention in autism. In J. R. Weisz & A. E. Kazdin (Eds.), Evidence-based psychotherapies for children and adolescents (pp. 312–326). The Guilford Press.

    Google Scholar 

  • Smith, T., Buch, G. A., & Gamby, T. E. (2000a). Parent-directed, intensive early intervention for children with pervasive developmental disorder. Research in Developmental Disabilities, 21, 297–309.

    Article  PubMed  Google Scholar 

  • Smith, T., Groen, A. D., & Wynn, J. W. (2000b). Randomized trial of intensive early intervention for children with pervasive developmental disorder. American Journal on Mental Retardation, 105(4), 269–285.

    Article  PubMed  Google Scholar 

  • Smith, T., Klorman, R., & Mruzek, D. W. (2015). Predicting outcome of community-based early intensive behavioral intervention for children with autism. Journal of Abnormal Child Psychology, 43(7), 1271–1282.

    Article  PubMed  Google Scholar 

  • Sparrow, S., Cicchetti, D., Saulnier, C. (2016). Vineland Adaptive Behavior Scales, Third Edition. Pearson Assessments

    Google Scholar 

  • Sundberg, M.L. (2008). VB-MAPP Verbal Behavior Milestones Assessment and Placement Program***: A Language and Social Skills Assessment Program for Children with Autism or Other Developmental Disabilities. AVB Press.

    Google Scholar 

  • Towle, P., Patrick, P., Ridgard, T., Pham, S., & Marrus, J. (2020). Is earlier better? The relationship between age when starting early intervention and outcomes for children with autism spectrum disorder: A selective review. Autism Research and Treatment, https://doi.org/10.1155/2020/7605876

    Article  PubMed  PubMed Central  Google Scholar 

  • Usry, J., Partington, S. W., & Partington, J. W. (2018). Using expert panels to examine the content validity and inter-rater reliability of the ABLLS-R. Journal of Developmental and Physical Disabilities, 30(1), 27–38.

    Article  Google Scholar 

  • Venter, A., Lord, C., & Schopler, E. (1992). A follow-up study of high-functioning autistic children. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 33(3), 489–507. https://doi.org/10.1111/j.1469-7610.1992.tb00887.x

    Article  PubMed  Google Scholar 

  • Vietze, P., & Lax, L. (2018). Early intervention ABA for toddlers with ASD: Effect of age and amount. Current Psychology. https://doi.org/10.1007/S12144-018-9812-Z

    Article  Google Scholar 

  • Waters, C. F., Amerine Dickens, M., Thurston, S. W., Lu, X., & Smith, T. (2020). Sustainability of early intensive behavioral intervention for children with autism spectrum disorder in a community setting. Behavior Modification, 44(1), 3–26. https://doi.org/10.1177/0145445518786463

    Article  PubMed  Google Scholar 

  • Weiss, M. J. (1999). Differential rates of skill acquisition and outcomes of early intensive behavioral intervention for autism. Behavioral Interventions, 14, 3–22.

    Article  Google Scholar 

  • Wong, V., McGrew, J., & Ruble, L. (2020). Predicting the outcomes of parents of transition-age youth or young adults with ASD. Journal of Autism and Developmental Disorders, 50(8), 2723–2739. https://doi.org/10.1007/s10803-020-04362-1

    Article  PubMed  Google Scholar 

  • Zachor, D. A., & Itzchak, E. B. (2010). Treatment approach, autism severity and intervention outcomes in young children. Research in Autism Spectrum Disorders, 4(3), 425–432. https://doi.org/10.1016/j.rasd.2009.10.013

    Article  Google Scholar 

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Funding

University of Arkansas College of Education and Health Professions.

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Authors and Affiliations

  1. University of Arkansas, Fayetteville, USA

    Aaron J. Myers, Peggy J. Schaefer Whitby, Allison Ames Boykin, Karan Burnette, Renee Holmes & Nnamdi Ezike

  2. University of Central Arkansas, Conway, USA

    Elizabeth Cleveland

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  1. Aaron J. Myers
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  2. Elizabeth Cleveland
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  3. Peggy J. Schaefer Whitby
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Contributions

PSW, EC, and KB conceived of the presented research idea. AM and NE developed the theory and performed the computations under the direction of AAB. AAB verified the analytic methods. AA, EC, and PSW contributed equality to writing the initial manuscript. KB and RH contributed expert content validity and database development. All authors discussed the methods, results and contributed to the final manuscript.

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Correspondence to Peggy J. Schaefer Whitby.

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Myers, A.J., Cleveland, E., Whitby, P.J.S. et al. Analysis of a Statewide Early Intervention Program for Young Children with ASD. J Autism Dev Disord 52, 4994–5006 (2022). https://doi.org/10.1007/s10803-021-05376-z

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